Achilles Tendon Rupture

What is an Achilles Tendon Rupture?

An Achilles tendon rupture is the complete or partial separation of the fibrous band that extends from the heel to the calf muscle. It most often occurs in older people and those who have not fully conditioned leg muscles before running, cycling and participating in other physical activities.

However, other situations can cause a partial tear or a complete rupture. They include falling or jumping down from an elevated area, inadvertently stepping in a hole or a sudden increase in normal levels of physical exertion. Sudden movements can tear or completely sever the tendon. In some cases, an MRI is required to diagnose an Achilles tendon rupture, but more often than not it can be determined by a physical exam.

What are the Symptoms of an Achilles Tendon Rupture?

The symptoms of an Achilles tendon rupture are extreme pain in the calf muscle and the inability to walk normally. A sudden snap or shot may be felt when it occurs, but not always. Some people have no symptoms of a tear, but most people will experience at least one of the following symptoms in addition to pain and problems with walking.

Symptoms include

  • Inability to raise up on the toes of both feet
  • Inability to put weight on the injured limb
  • Swelling around the heel

Achilles Tendon Rupture Causes

The Achilles tendon can rupture from any activity that requires sudden stops, starts, and pivots. This includes gymnastics, running, baseball, basketall, football, volleyball, essentially all types of ball games; dancing, and many other activities. If you suddenly speed up, slow down, or pivot, you’re at risk of an Achilles tendon injury. Why? We typically push off the ground at the start of these movements, and the action can sometimes be too abrupt for the tendon. Especially if you are a male over the age of 30.

Other factors can contribute to a ruptured Achilles tendon:

  • high heels (stress on the tendon)
  • flat feet (too much stretching)
  • tight leg muscles or tendons
  • glucocorticoids or antibiotic medications called fluoroquinolones medicines
  • falling from a height
  • stepping in a hole
  • steroid injections (weakening the tendon)
  • obesity (added strain on the tendon)
  • extending an exercise for a longer period of time
  • changing the surface used for an activity (grass to street, for example)
  • uneven leg length
  • pronation of the feet (over or under)
  • short or tight Achilles tendons or calf muscles
  • weak calf muscles
  • misshapen foot bones

How is an Achilles Tendon Rupture Treated?

A ruptured Achilles tendon may be treated using surgical and nonsurgical methods. It often depends on the age of the patient, severity of the injury and the individual’s activity level.

Nonsurgical Treatment

Nonsurgical methods are often chosen for less active and/or older people. A walking cast, boot or heal wedge is worn during the recovery period. However, it can take longer to heal when choosing immobilization over surgery.

Surgical Treatment

Surgery may be the best course of action when the Achilles tendon is completely ruptured. Risk of subsequent injury and recovery time is lessened. However, risk of infection increases.

Either way, physical therapy is vital for rehabilitation. On average it takes between four and six months to fully heal.

Achilles Tendon Rupture Prevention

If you suffer a rupture and have surgery, you shouldn’t return to normal activities until your doctor gives you permission. Your doctor can provide exercises to do while you heal. Don’t resume a full workout until your injured leg feels as loose, strong, pain-free, and flexible as your uninjured leg.

You can prevent ruptures with a few sensible precautions:

  • Warm up and stretch before exercising
  • Stretch between exercises
  • Strengthen leg muscles, especially calf muscles
  • Decrease uphill running
  • Do aerobic activities before performing strength exercises
  • Wear shoes that fit correctly and provide adequate support
  • Test for injuries after a workout
  • Discontinue exercise activities if pain or tightness occurs in the back of the calf or heel

 

Resources
Last Reviewed:
September 11, 2016
Last Updated:
June 02, 2018